A retrospective trial of percutaneous release for 40
trigger thumbs in 33 children under different types of
anesthesia (general versus local) at a mean age of 2.5 years was conducted between February 1989 and March 2003. Based on the tolerance of the child and parents, 20 children were processed using
local anesthesia at our office and 13 children were given
general anesthesia. We recommend special manipulation to ensure complete release of the A1 pulley when
general anesthesia is necessary. Of the 26
trigger thumbs in the
local anesthesia group, 23 were successfully released. Only one patient in the
general anesthesia group had an unsatisfactory outcome. Percutaneous surgery achieved a 90% successful release rate for
trigger thumb in children, without recurrence. There was no statistical difference in the release of
trigger thumbs with these two
anesthetic procedures (p = 0.66). Overall, 37
trigger thumbs achieved full extension and flexion without any residual
deformity following percutaneous release. Our results suggest that percutaneous release for
trigger thumb is satisfactory, no matter which method of
anesthesia is used.